Options available to treat endometriosis; awareness needed

ALBANY — The U.S. Department of Health and Human Services Office of Women’s Health defines endometriosis as a condition in which the endometrium, or lining of the uterus, grows outside of the uterus. The agency said the condition may affect more than 11 percent of American women between the ages of 15 and 44.

Those statistics might prompt women of childbearing age to understand endometriosis and the treatment options that are available.

“The biggest symptom of it is pain,” Dr. Donna Graf, a physician with Southwest Georgia OB/GYN, said.

Endometriosis can cause pain as well as infertility, particularly if there is scarring on the fallopian tubes as a result of the condition. A woman can experience strong pelvic pain, cramping that is more painful than usual during their typical menstrual cycle, as well as back and side pain. There are multiple theories about what causes it.

Graf said the displaced endometrium glands can be found in the fallopian tubes, ovaries, bladder, along a caesarean section incision line and in the bowel.

Endometreosis is typically diagnosed by a biopsy in the suspicious spot where there is a blood-filled cyst to identify the displaced glands as coming from the uterus. Graf said a woman who has a sister or mother who had endometriosis is seven to 10 times more likely to develop it.

“It can happen to anybody, but there is a strong familial association,” she said.

The Albany physician said it is unlikely there is enough awareness about the condition. Many women may have it and not know it, thinking that their cycles have become worse for no reason.

“Those are the ladies you want to get in to be seen,” she said.

The first method used in most cases is birth control pills to regulate hormones, or non-steroidal anti-inflammatory drugs. Graf said intrauterine devices can also help by keeping endometrium implants inactive.

Laparoscopic surgery is a form of treatment as well. Surgeries to remove the uterus or ovaries can be used as treatment in extreme cases — particularly depending on the woman’s age.

“Hysterectomy is far on the list,” Graf said. “For a 23-year-old, we would try other methods first.”

Graf said the bottom line is if a woman simply cannot function once a month, she needs to look into treatment options — and their friends, family and co-workers should be encouraging them to do the same. If a woman is trying to get pregnant for more than a year and is unable to, that is also a sign something may be wrong.

“(In those cases), that lady needs some attention,” she said. “Also, know your family history.”

Graf said the variety of birth control pills has increased over the last 20 years, and non-invasive forms of surgery have become more advanced since then.

Women in southwest Georgia should be able to find options available to help them.

“There are more effective options out there (now),” Graf said. “Endometriosis is still the same, but the options have varied a little bit. (In southwest Georgia) there are good ultrasounds, and physicians are well-versed in laparoscopic options and techniques.”

Another important thing to keep in mind is that, only in more severe cases will a woman be unable to have children after she develops endometriosis, Graf said.

“It is not a pre-cancerous condition,” she said.